Prison deaths: a national shame

December 06, 2006|By Ira P. Robbins

WASHINGTON -- While the alleged human rights abuses of prisoners detained in Guantanamo Bay and the Middle East have sparked widespread criticism and debate in this country and abroad, surprisingly little attention has been focused on the treatment of citizens imprisoned within our borders. Each year, approximately 7,000 Americans die in U.S. prisons and jails. Some of these deaths are from natural causes, but many more result from mental disorders left undiagnosed and diseases left untreated.

The abhorrent quality of correctional health care not only violates prisoners' constitutional rights, it costs taxpayers millions of dollars and threatens the general health of communities surrounding these facilities. Understanding why prisoners die is an essential first step in identifying the major pitfalls of our health care system. Passing legislation to correct these problems is the crucial next step. Therefore, Congress should extend and strengthen the Deaths in Custody Reporting Act, or DICRA, before it expires at the end of this year.

An investigative series revealing the questionable circumstances in thousands of deaths in police and prison custody led then-Rep. Asa Hutchinson to introduce DICRA in 2000. Before DICRA, data collection on prison deaths was incomplete, mostly because states lacked the incentive to participate. Further, data were inaccurate because states had inconsistent reporting methods, and the Bureau of Justice Statistics of the U.S. Department of Justice only required prisons to report aggregate death statistics rather than the facts of individual cases.

DICRA created a systematic program for tracking all deaths in custody, highlighting prisons with the highest percentages of prisoner deaths, and facilitating the improvement of prisoner health care. Under the new reporting scheme, all states receiving funds from certain federal grant programs must report, on a standardized form, the demographic profiles of all dead prisoners and the specific circumstances of each death in custody.

The main benefit of reporting statutes like DICRA is that they provide essential information for future resource and policy decisions. For example, the Hate Crime Statistics Act and the Prison Rape Elimination Act supplied the data necessary to establish national standards and to implement effective training programs. DICRA has provided important statistics about the prevalence of prison deaths, but Congress has not used the data to enact legislation to achieve DICRA's purpose, as it has done with these other reporting laws.

When Congress passed DICRA, the Bureau of Justice Statistics anticipated that the comprehensive statistics would enable it to make various improvements in correctional health care, inmate classification, suicide prevention, correctional staff assignment and training, facility design, and law enforcement weapons/use-of-force training. But these goals have not materialized - and they will not, unless Congress passes additional legislation.

DICRA is a perfect starting place for major prison reform regarding preventable deaths. Yet it is only a starting point. Congress must put the data to good use by enacting legislation to create national standards, ensure greater accountability in the reporting of prison deaths, require more expert analysis on the ways to prevent these deaths, and provide additional training for prison officials on how to respond to sick and dying prisoners. Skeptics should look to Massachusetts as an example for how such programs can be effective. The mortality rate in Massachusetts prisons became one of the lowest in the country when state officials used DICRA data to train workers to identify inmates who are at risk for serious health problems or suicide.

Although additional legislation would require spending public funds on a population for whom most Americans feel little sympathy, the public has an enormous stake in ensuring the continuation and enhancement of DICRA. Legislation that holds correctional institutions and individuals accountable for preventable deaths will be less financially burdensome to taxpayers in the long run.

Comprehensive prison health care avoids expensive and time-consuming court proceedings over claims of inadequate care that often result in large monetary settlements paid to prisoner plaintiffs. Proper treatment of health conditions before they escalate also eliminates the need for more costly treatments in the future. Moreover, inadequate prison health care has a direct effect on the health of our communities. Communicable diseases like tuberculosis, Hepatitis C and HIV reach the public through released prisoners and those who visit or work inside the prisons.

The divisiveness of prisoners' rights as a political issue is no excuse for congressional inaction. Continued DICRA reporting is essential to making prisons a more humane part of the justice system and to ensuring that the government fulfills its duty to provide proper medical care to prisoners.

Ira P. Robbins is professor of law and justice at American University Washington College of Law and the author of "Prisoners and the Law." His e-mail is robbins@wcl.american.edu.